Guide for a diabetic to fast during Ramzan

Mumbai: As the holy month of Ramzan begins around 180 million Muslims in India will be fasting for the entire month as a form of worship along with charity.

The Ramazan fast is a long one with the gap between meals that ranges from from 12 to 15 hours but this can lead to severe health problem for diabetic patients.

People suffering from diabetes are recommended to eat meals at regular intervals. However, fasting results in metabolic changes and calls for an adjustment in the diabetes management plan.

“If you are a diabetes patient it is advisable to speak to your doctor if you wish to fast. If your doctor allows you to fast, it is recommended to follow the diet and medication that your doctor has prescribed,” said Dr. Shehla Shaikh, Consulting Endocrinologist, Saifee Hospital, Wockhardt Hospitals and Prince Aly Khan Hospital.

“Patients are required to monitor their blood glucose level at regular intervals in the day during fasting and immediately consult their physician if they notice any changes. In case a patient is on insulin there may be a need to change the kind and dosage of insulin,” she added.

Patients suffering from type 1 diabetes with a history of recurrent hypoglycemia are at a higher risk if they are fasting. There are chances that hypoglycemia and hyperglycemia may also occur to patients with type 2 diabetes. The only difference is that the risk is higher for patients with type 1 diabetes.

How does fasting affect diabetic patients?

• Fasting can precipitate dramatic changes in meal schedule, sleeping pattern and circadian rhythms.
• Patients with diabetes who are fasting may have complications like hypoglycemia, diabetic ketoacidosis, dehydration and thrombosis.

How should a diabetic patient prepare for the fast?

• Patients should undergo a detailed medical evaluation regarding his or her fitness.
• Appropriate changes in medication should be made and details regarding diet, exercise, monitoring of sugars and termination of fast should be given if required.
• It is critical for patients to regularly monitor their blood sugar levels throughout the day.

Complications:

• Sudden fall in blood sugar levels (hypoglycaemia), causing seizures and unconsciousness
• An inordinate increase in blood sugar levels (hyperglycaemia) causing blurry vision, headache, increased fatigue and thirst.
• Diabetic ketoacidosis, a potentially life-threatening complication that causes vomiting, dehydration and coma
• Thrombosis which leads to formation of a blood clot inside blood vessels, potentially a precursor to organ damage and even death.

What to eat and what not to eat:

• At Iftar, break your fast with sugar-free and decaffeinated fluids to avoid dehydration.
• Limit the consumption of sweets.
• Include fruits, vegetables, pulses and curd in your diet.
• Do not sleep soon after your dinner, allow an interval of 2 hours
• At Sehri, ensure the right nutrient intake. Suggested items include whole grain bread, whole grain low sugar cereals, beans and lentils.
• Avoid deep fried foods such as parantha, puri, samosa, chwera and pakoras.
• Consume starchy items such as rice and wheat chappati in moderation.